Hyperthermia as a safe and effective cancer treatment modality is rapidly evolving propelled by widespread research and clinical efforts worldwide. Presentations on Hyperthermia experience are now commonplace at Oncology meetings, as are congresses dedicated entirely to the intertwined interactions between basic sciences and patient treatment that together are forming the structure of a new medical specialty. Such was the XII International Symposium on Clinical Hyperthermia held in Rome, Italy, April 27 - 29, 1989. Papers presented therein constitute the backbone of this book. Biology research has provided data describing mechanisms of action for the cancer cell killing and physiological effects of Hyperthermia. Physics research has led to the development of equipment enabling treatment of many areas of the human body, as well as explained the limitations that still constrain our ability to treat, especially in the areas of deep seated tumor heating and non-invasive thermometry. The main question that will decide the future of this modality is that of its clinical use. To put it succinctly, what do we do with this potentially useful tool in an everyday clinical oncological practice . •• ? This is the main question addressed in this book as "Consensus on Hyperthermia for the 1990s. " The book in cludes 28 presented papers and 25 invited chapters from some of the leading experts in the field. Their basic mechanisms of action were physics principles, treatment quality assurance and especially, clinical indications.

Hyperthermia has been found to be of great benefit in combination with radiation therapy or chemotherapy in the management of patients with difficult and com plicated tumor problems. It has been demonstrated to increase the efficacy of ionizing radiation when used locally but also has been of help in combination with systemic chemotherapy where hyperthermia is carried out to the total body. Triple modality (thermo-chemo-radiotherapy) or other treatment combinations have not been fully evaluated and may demonstrate extended clinical applications in the future. Problems remain with regard to maximizing the effects of hyperthermia as they are influenced by a variety of external and intrinsic factors including bloodflow, microenvironment etc. While the previous volume has summarized more theoretical aspects of hyper thermia, i.e. biology, physiology and physics, the present volume compiles the current knowledge relative to the clinical applications of hyperthermia in combina tion with radiation therapy and/or chemotherapy, providing a comprehensive over view of its use in cancer management.

This book will deal with heat shock proteins and more generally with stress-related inducible gene expression as a pleiotropic adaptive response to stress. It presents a textbook-like overview of the field not only to heat shock experts, but to physiologists, pharmacologists, physicians, neuropsychologists and others as well. It is intended to be a state-of-the-art and perspective book rather than an up-to-date presentation of recent data. It should provide a basis for new experimetal approaches to fields at the edge of the classical heat shock field. Drugs, UV irradiation and environmental toxics will be considered as important modulators of the stress response. Radical scavengers such as superoxide dismutases and inducible regulatory proteins of metallic ion status such as ferritin as well as immunophilins and protein disulfide isomerases will be considered within the frame of stress proteins. The potential practical applications of heat shock proteins in toxicology and medicine for the diagnosis, prognosis and eventually therapy of clinical conditions associated with an increased oxidative burden will be outlined. The role of heat shock proteins in the modulation of immune responses will also be included. The book considers heat shock from a broad perspective including fields for which heat-shock may become of importance in the very near future such as cellular responses to environmental stresses and complex stress responses under specific conditions. It was also felt timely to incorporate a whole section on medical and technological applications of stress proteins. The book will be invaluable for all those working on stress and is intended for every "stress laboratory" as a source of knowledge and perspectives.

Following an introductory overview, Hyperthermia In Cancer Treatment: A Primer comprehensively describes the biological reasons for associating hyperthermia with radiation and chemotherapy and the biological and clinical effects of hyperthermia on cancerous and normal tissues. The volume’s 20 chapters are arranged in three principal parts: physical and methodological studies, biologic principles, and clinical studies.